Pulmonary melioidosis misdiagnosed as pulmonary tuberculosis

Abstract

is a facultative Gram-negative saprophytic bacterium commonly found in soil or contaminated water causing melioidosis. Melioidosis can mimic various other disease due to its heterogenous clinical manifestations and different organ involvement. Because of its versatility it is called as “the great imitator” and remains challenging to diagnose. We report a case of melioidosis misdiagnosed and treated as pulmonary tuberculosis. A 54-year-old male non-smoker with history of diabetes admitted with persistent cough, breathlessness and hemoptysis for 5 months. Initially there was pleuritic chest pain and high-grade fever. He was treated with multiple intravenous broad-spectrum antibiotics and anti-tubercular therapy multiple times in the local hospitals based on clinical symptoms and radiological manifestation though Sputum examination for AFB and Gene xpert for Mycobacterium tuberculosis was negative. Chest radiology showed multiple thick-walled cavities with pericavitary consolidation along with patchy infiltrative opacities. BALF culture identified . The respiratory morbidity was resolved using antibiotics based on antibiotic susceptibility tests. This case study described a case of melioidosis in adult male with diabetes and engaged in farming presented with diverse and indistinct clinical manifestations that mimics many other diseases. Definitive diagnosis was made by isolation , in culture collected through bronchoscopic examination.